Ulcerative Colitis

Question 1

Which age and sex is UC most common in

Answer 1

20-40

Females

Question 2

Where is the inflammation in UC

Answer 2

Maximal in the rectum and extends continuously and proximally to the colon

ONLY FOUND IN LARGE INTESTINE

Question 3

Different types of UC

Answer 3

Proctitis - localised to rectum
Distal colitis - rectum & sigmoid colon
Pancolitis - total colitis to caecum
Backwash ileitis - involvement of terminal ileum

Question 4

Presentation

Answer 4

Bloody diarrhoea
Weight loss
Abdominal pain

Question 5

In which intestinal layers is inflammation mostly found

Answer 5

Mucosa and submucosa

Question 6

What can be found in submucosa

Answer 6

Pseudopolyps
Ulceration into pseudopolyps
Fibrosis

Question 7

What happens to the crypts in UC

Answer 7

Cryptitis with abscess and disarray

Question 8

Are granulomas found in UC

Answer 8

no

Question 9

What premalignant changes can be seen in UC

Answer 9

Reactive atypia (flat epithelium)
Dysplasia

Question 10

Complications

Answer 10

Haemorrhage
Perforation
Toxic dilation

Question 11

What is toxic dilation and what does it lead to

Answer 11

When ulceration affects the muscle causing:

• weaker contractions
• distension of the colon
• thinning of wall predisposing to perforation

Question 12

Markers of a Severe attack

Answer 12

Stool frequency: >6 per day with blood AND

Fever: > 37.5
Tachycardia: >90
ESR (CRP): raised 
Anaemia: Hb <10
Albumin: <30
Leucocytosis (high WBC)
Thrombocystosis (high platelets)